title: The role of planar scintimammography with high-resolution dedicated breast camera in the diagnosis of primary breast cancer.
abstract: Planar scintimammography (SM) acquired with a conventional gamma camera has proved a useful complementary tool to mammography (Mx) in breast cancer (BC) diagnosis, but with unsatisfactory sensitivity in small size carcinomas. In this study we assessed the role of planar SM with a high-resolution dedicated breast camera (DBC) in BC diagnosis, comparing the results with those of Mx.A consecutive series of 145 patients scheduled for biopsy for suspected BC underwent Tc-99m tetrofosmin planar SM using a newly developed DBC. Scintigraphic data were compared with Mx findings and correlated to histology.Histopathologic analysis revealed 165 lesions: 143 malignant and 22 benign. SM detected 139/143 carcinomas (overall sensitivity: 97.2%) and was true negative in 19/22 benign lesions (overall specificity: 86.4%). SM sensitivity was 91% in < or =10-mm carcinomas. SM was more accurate than Mx in 42/145 cases (29%), detecting cancer in 9 patients with Mx indeterminate for dense breasts (8/9 tumors were <10 mm), assessing additional tumor foci (all <10 mm) in 5 points with multifocal disease and correctly classifying 28 patients with inconclusive mammographic findings as affected by cancer or by benign disease. Mx was more accurate than SM in 3 patients, in each detecting 1 subcentimeter BC false negative on SM.DBC planar SM seems a highly sensitive diagnostic tool in the detection of BC, even when small in size, and in the assessment of multifocal disease. A wider employment of this procedure is thus suggested, especially in indeterminate or inconclusive mammographic findings to improve sensitivity and specificity of Mx.
authors.affiliation: Department of Nuclear Medicine, University of Sassari, Sassari, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Spanu
authors.forename: Francesca
authors.initials: F
authors.lastname: Chessa
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Meloni
authors.forename: Daniela
authors.initials: D
authors.lastname: Sanna
authors.forename: Pierina
authors.initials: P
authors.lastname: Cottu
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manca
authors.forename: Susanna
authors.initials: S
authors.lastname: Nuvoli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Madeddu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008327:Mammography / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging / Q000295:instrumentation*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin